Flores-Rivera A R, Silva-Pintado A, Bautista-García J J, Espinosa-Ostos D
Servicio de Cirugía General, Hospital General de Zona con Medicina Familiar No. 1, Hidalgo, México.
Bol Med Hosp Infant Mex. 1991 Feb;48(2):117-20.
This is a case report of extravaginal twisting of the spermatic cord in a neonate (third pregnancy, without prenatal care, obtained through iterative cesarean section), which occurred during the prenatal (in uterus) period since it was present at birth. Clinically found were: an enlargement of the right hemiscrotum, color changes (violet), induration, absence of the cremasteric reflex and no translumination. Ultrasonography showed homogeneous opaqueness of the right scrotal pouch. Right radical orchiectomy was carried out after finding testicular necrosis. The differential diagnosis includes: tumor, hematocele, testicular twist of the epidydimus appendexes, incarcerated hernia, scrotal abscess, supradrenal gland or ectopic spleen and the twisting of the spermatic cord. All of these conditions require immediate surgical exploration through the inguinal region in order to obtain a correct diagnosis and give prompt treatment. If there is twisting, contralateral fixation is necessary.
这是一例新生儿精索鞘膜外扭转的病例报告（第三胎妊娠，未进行产前检查，经多次剖宫产娩出），因其出生时即存在，故在产前（子宫内）阶段就已发生。临床检查发现：右侧阴囊肿大、颜色改变（呈紫色）、硬结、提睾反射消失且不透光。超声检查显示右侧阴囊袋呈均匀不透明状。发现睾丸坏死后进行了右侧根治性睾丸切除术。鉴别诊断包括：肿瘤、血囊肿、附睾附件扭转、嵌顿疝、阴囊脓肿、肾上腺或异位脾脏以及精索扭转。所有这些情况都需要通过腹股沟区立即进行手术探查，以便获得正确诊断并及时治疗。如果发生扭转，对侧固定是必要的。
